Individual provider Active NPI

Christine M Kerno, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1730357443
Registry record updated Sep 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13628 Issued in MN
Practice address
3249 Hennepin Ave Ste 210a
Minneapolis, MN 55408-3413
Phone
(612) 214-0447
NPI assigned
Feb 15, 2008
Last updated
Sep 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13628 MN Primary

Addresses

Primary practice location

3249 Hennepin Ave Ste 210a
Minneapolis, MN 55408-3413

Mailing address

3249 Hennepin Ave Ste 210a
Minneapolis, MN 55408-3413
Phone (612) 214-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200103000791 MN Practitioner - Clinical Social Worker 7911127584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13628MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Program Solutions, LLC CurrentSince Nov 17, 2019 Accepting new patients
JLS Consulting, Inc Clinical Past Accepting new patients
Christine Kerno, MSW, Licsw Clinical PastSince Oct 15, 2014 Accepting new patients

Locations

3249 Hennepin Ave
Ste 210A
Minneapolis, MN 55408
Phone (612) 214-0447

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568505600000",
    "number": "1730357443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 HENNEPIN AVE STE 210A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083413",
            "telephone_number": "612-214-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 HENNEPIN AVE STE 210A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083413",
            "telephone_number": "612-214-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNO",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2019-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.